Just as other diseases have signs or symptoms, so does schizophrenia. Symptoms are not identical for everyone. Some people may have only one episode of schizophrenia in their lifetime. Others may have recurring episodes, but lead relatively normal lives in between. Others may have severe symptoms for a lifetime.
Schizophrenia always involves a change in ability and personality. Family members and friends notice that the person is "not the same." Because they are experiencing perceptual difficulties -- trouble knowing what is real from what is not real -- the person who is ill often begins to withdraw as their symptoms become more pronounced. Deterioration is usually observed in:
Work or academic activities Relationships with others Personal care and hygiene
CHARACTERISTIC CHANGES
Personality change is often a key to recognizing schizophrenia. At first, changes may be subtle, minor and go unnoticed. Eventually, such changes become obvious to family, friends, classmates or co-workers. There is a loss or lack of emotion, interest and motivation. A normally outgoing person may become withdrawn, quiet, or moody. Emotions may be inappropriate -- the person may laugh when told a sad story, or cry over a joke -- or may be unable to show any emotion at all.
Thought disorder is the most profound change, since it prevents clear thinking and rational response. Thoughts may be slow to form, or come extra fast, or not at all. The person may jump from topic to topic, seem confused, or have difficulty making simple decisions. Thinking may be coloured by delusions -- false beliefs that have no logical basis. Some people also feel they are being persecuted -- convinced they are being spied on or plotted against. They may have grandiose delusions or think they are all-powerful, capable of anything, and invulnerable to danger. They may also have a strong religious drive, or believe they have a personal mission to right the wrongs of the world.
Perceptual changes turn the world of the ill person topsy-turvy. Sensory messages to the brain from the eyes, ears, nose, skin, and taste buds become confused -- and the person may actually hear, see, smell or feel sensations that are not real. These are called hallucinations. People with schizophrenia will often hear voices. Sometimes the voices are threatening or condemning; they may also give direct orders such as, "kill yourself". There is always a danger that such commands will be obeyed.
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